Where are those outcomes I ordered?

It’s a little hard to remember what life was like before Amazon two-day shipping.

I recently listened to a podcast describing how Amazon achieved two-day shipping, back in 2005, speeding up what used to take up to five days. It was an incredible transformation in the process of fulfillment, which entails ordering, managing the warehouse, shipping and tracking. Amazon had to completely stop what they were doing and reinvent from the ground up. They had to anticipate what would be ordered, where, and by whom. They had to get your order in a box and out of the shipping center in less than four hours. They had to locate, label and box your order in a way that would be acceptable to shippers, that could be stacked and sent anywhere. It’s the purposeful alignment and tuning of a system of processes from before you order to when it’s at your house that makes the outcome possible.

What Amazon didn’t do was just promise you they would deliver in two days and then demand everyone in the organization speed up, or else! You can just imagine how that would have gone. You would still be getting your orders in about five days, but there would be internal reports about the failures to meet the target, staff would be written up for not boxing fast enough, and consumer protection agencies would be writing reports about Amazon failing to deliver on their promises. They would have failed.

But too often that’s what we are doing in Child Welfare. For measure after measure, a target is set that seems appropriate but without a process designed to achieve it. Therefore, the organization is set up for failure from the beginning. This failure to achieve the targets generate staff reprimand, lists to track the failures, QA reports, visits from Federal Partners, and lawsuits. The noble work of child welfare succumbs to the reality of misaligned processes and insufficient capacity to achieve unrealistic targets.

Consider the Child and Family Services Review (CSFR) Well Being Outcomes, specifically meetings with parents and children. Across the country results vary: some states see just over 50% of parents each month, and 70-80% of children, and the quality of the visits varies significantly. But no jurisdiction is meeting the outcome of visiting all parents and children each month. From the outside, it seems obvious that every child should meet with his/her caseworker every month while he/she is in care. But working with caseworkers, they don’t have a method or time to achieve the measure. They feel the stress, but they can’t get to every child or parent with the current process and caseloads. The target is set, but the system can’t produce the result.

There is a saying that, “systems are finely tuned to give you the exact results you are getting. If you don’t like the results you have to change the process.” Wishing doesn’t change the process. Setting targets doesn’t change the process. Accountability doesn’t change the process. Only changing the process changes the process.

The system as designed doesn’t have the capacity to ensure child and parent visits happen. By setting a target without a mechanism in place to develop new methods, you see a shift to an accountability target, and we see this happen time and time again. Targets become fear-based and staff focus on how to avoid punishment. There is no designed and managed process that ensures that the visits happen. If a measure is truly important, a process must be created to generate sufficient capacity to allow the organization to achieve the target.

When we redesign processes with caseworkers, we find that more capacity exists. During redesign, we remove the bottlenecks, duplication, inefficiency and find methods to optimize both the work time and minimize the elapsed time. We increase capacity by 40% or more through this effort. Based on the new level of organizational capacity, we then evaluate and determine what outcomes are reasonable and that we should expect to see. And then – and only then – do we monitor to see the results of the new approach, but this time the focus is not driven by accountability to a target, but rather accountability to the process. This redesign and newly established measures and targets result in more achievable child welfare caseflow with less need for heroism in the midst of chaos. It results in something repeatable and predictable.

You can’t order your way to improved outcomes any more than Amazon could simply demand two-day shipping. It doesn’t work that way.

Now, I wonder where Amazon left those Avenger’s napkin holders I ordered?

You May Also Like…

Band of Brothers

Band of Brothers

Management-by-Fear is the current fad. Across the country, in conference rooms of every size, governors are looking at...

read more

Transform how the work of government gets done

Using our proven and unique methods, we challenge the government’s status quo. While many focus on tackling symptoms, we focus on underlying problems (which are almost always tied to broken systems) to help you increase your capacity to do all the good our citizens need us to do in this world.

Cutting Edge Technology for Public Sector

We're reinventing the way states administer safety net programs such as Medicaid, SNAP (food stamps), child care, and unemployment insurance. With our cutting-edge technology, we’re helping agencies help more people, faster, and transforming healthcare service delivery as we know it.

Manage on-site and virtual operations in one seamless solution

Accelerate eligibility decisions for quicker access to benefits

Partners for a brighter future

While C!A’s team understands the status quo of government, they are not afraid to challenge it with new thinking.  It is this new thinking that has led to our clients’ success and helped them create a new way of doing government business.

About Change & Innovation

Public servants by experience and at heart, Change & Innovation Agency’s (C!A®) team understands first-hand the challenges that you and your team face as you work to deliver vital safety net benefits to children and families in need.

Our Team

Together, we work with you and your team to increase your capacity to do more good.

It all comes down to timeliness — how quickly you can deliver services to those who need them. That’s what our families care about, that’s what our legislators care about. With the transition to process management, we’ve turned our cycle time around. Applications that used to take 22 or 23 days to process, now take an average of 5.

Ronald Kreher, Director Department of Health and Social Services,State of Alaska Division of Public Assistance

Thought Leadership

Learn more about human services innovation through this collection of articles written by our team of change agents

Newsroom

Read the latest news from Change & Innovation Agency

Capacity Calculator

Calculate the resources you need to increase your agency capacity

Case Studies

Learn about some of the greatest challenges facing government today and how government systems can be improved.